Saying goodbye - the ins and outs of euthanasia. Photo/ file
As New Zealand edges closer towards legalising euthanasia, reporter Emma Russell takes a closer look at what is being proposed.
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"You're asking me to kill someone," a doctor says with a slight chill when the word euthanasia is uttered across the table.
He pauses, looks down at his notes, shakes his head, then continues, "it goes against everything my training and medical experience has taught me, it goes against our medical oath".
A former hospice nurse thinks differently.
"I have seen patients who cannot control their bowels or bladder, who can barely move, and who are unable to communicate with their families.
"I see voluntary euthanasia as a way to relieve those people of that suffering if they choose - and to die with dignity."
Two opposing views. Two long-standing health professionals. Two people who have worked on the frontline of palliative care for two decades - each representing a national divide on legalising voluntary euthanasia.
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In June last year, ACT leader David Seymour introduced the End of Life Choice Bill that, if passed, would legalise voluntary euthanasia.
The bill was debated at its first reading in December last year and passed with 76 votes in favour and 44 against.
It was then handed over to a select committee for review and public submissions were collected.
So far, the committee has processed more than 30,000 public submissions and has thousands more to go.
"This is already the highest number of submissions a select committee has received in recent Parliamentary history," Justice Committee chairperson Raymond Huo said.
Why then, has this bill gained so much traction? It's not the first time legalising euthanasia in New Zealand has been proposed.
In 1995 Whanganui's former mayor, a Member of Parliament (MP) at the time, Michael Laws, sought to introduce a Death with Dignity Bill. It failed to get into the House, but generated a great deal of publicity.
Then in 2003, former MP Peter Brown put forward a second Death with Dignity Bill. The bill made it to the first reading but it was defeated in a conscience vote for MPs 60 votes to 58.
The End of Life Choice Bill signals the closest New Zealand has ever got to legalising euthanasia.
It proposes that if a person is terminally ill and is likely to die within six months or has "grievous and irremediable medical condition" they can request medical aid to die. But they must be of a fit mind.
To be eligible for "assisted dying", the bill proposes that a person must: be over 18, be a New Zealand citizen or a permanent resident, be terminally ill and likely to die within six months or have a grievous and irremediable medical condition, be in an advanced state of irreversible decline in capability, be experiencing unbearable suffering that cannot be relieved in a manner that he or she considers tolerable, and who has the ability to understand "assisted dying" and the consequences.
Retired Whanganui doctor Jonathan Hartfield says this is the biggest problem with the bill - "it doesn't even mention the word euthanasia, it's so coy about it".
"A grievous irremediable medical condition - how is that defined? Guessing how long someone has to live can be very hard to say. Yes, with cancers it is easier but other medical conditions like kidney failure it's very hard.
"People have been trying to work out schemes to do that for years and have all failed," Hartfield said.
Former South Taranaki Hospice community nurse Sue Walkinton agrees the bill does need tweaking, but the way she sees it is that there are two types of people who fit into the bill as it stands.
"One is people who have a terminal illness which means there is no further treatment available. The other is people with awful neurological diseases such as Multiple Sclerosis and Huntington's disease where there is no cure and their lives are brutal."
Hartfield is adamant palliative care can help everyone.
"In all my experience, I have never met anyone who has suffered from all these terrible things that are being talked about, which by the way is making the public very scared of dying."
He said palliative care offered comfort, a gentle death, relief of symptoms, spiritual care and care to relatives and a bereavement service.
"My recommendation is one should try palliative care for three months before becoming eligible to ask for euthanasia, because if palliative care works then there is no need for euthanasia."
As a nurse, Walkinton says she has seen the suffering others talk about.
"Palliative care has many benefits but unfortunately it doesn't help everyone. As a nurse we're the ones with people dying, we get close to the patients."
She said a lot of what was already happening could be seen as illegal.
"There would hardly be a doctor in this country who has not hastened death."
Walkinton tells me about a former colleague of hers who gave the maximum amount of medication prescribed by a doctor, and as a result that patients' death was hastened.
"It wasn't euthanasia but death was hastened, so you see it's very muddy words.
"And that patient didn't make that choice, the doctor did. In the future, if the family had turned around and said their loved one was dying more rapidly, we need protecting."
Hartfield's argument to that - while a person may become unconscious, the intention is not to kill them.
"If you had a better drug to keep them awake but out of pain then you would use that better drug."
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Walkinton said under the bill, a person would be euthanised with a drug called Pentobarbitone, an imported muscle relaxer and the same drug vets use.
"We've seen it used on animals and we know it's instant."
Hartfield isn't convinced.
"Euthanasia is not 100 per cent dignified, some take the drug and vomit it up or wake up four hours later ... about 7 per cent will have some sort of complication," he said.
And he raises another issue. "If we say assisted dying is legal, what does that say to a teenager who's considering doing himself away.
"It would make it easier for someone to kill themselves and it would runs the risk of normalising suicide.
"There is danger in euthanasia becoming so common that people start to think I'm getting a bit of burden, I'm 75, probably I want to go ask for euthanasia ... which is a real shame," Hartfield said.
Walkinton doesn't see it that way.
"I had a patient a few years ago who died a horrible death, and her lovely husband just couldn't cope so he hung himself. He was healthy but he wanted out. This is how elderly people are killing themselves."
The bill states that a person who requests assistance to die must be seen by two doctors. Any doctor can refuse to be involved but they must refer the patient to a doctor who can assist them.
Which does beg the question, how many doctors are willing?
The bill is yet to confirm that information.
The New Zealand College of General Practitioners, representing nearly 90 per cent of doctors, has taken a neutral standpoint and the New Zealand Medical Association, with about 3000 doctors, is against it.
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Walkinton wishes there wasn't this barrier between hospice and euthanasia advocates because at the end of the day both want a gentle death.
"The world has changed. What we are doing these days is extending people's lives far beyond what's sometimes reasonable. Euthanasia needs to be looked at - now more than ever."
Euthanasia in New Zealand Court
In April 1999, John Karnon was sentenced to two years of supervision after he pleaded guilty to manslaughter over the death of his ill wife.
In October 2001, doctor Chris Simpson was convicted of manslaughter after his terminally ill mother was found dead in October 2000. He was sentenced to three years' imprisonment.
In August 2002, Rex Law was sentenced to 18 months in jail for the death of his ill wife in March 2002. He served nine months.
In May 2003, Ralph Vincent faced charges for assisting his ill wife to die but the charges were later dropped.
In 2004, a Nelson man was found not guilty of the murder of his 5-month-old daughter. Baby C had the brain of a 13-week old fetus and her parents were told it would never develop beyond that.
In March 2004, Whanganui's Lesley Martin was sentenced to 15 months' imprisonment after admitting in her book, To Die Like a Dog, she twice tried to assist her mother to die in 1999.
In February 2018, Susan Austen received a mixed verdict for assisting Annemarie Treadwell to die by supplying her with imported Class C controlled drug, pentobarbitone.
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